The early rectal cancer which needs conservative surgical treatment should present some pathological caracters: intra mucosal site without muscolaris invasion (pT1), high or moderate differentiated grading (GI-G2), no lymphonode metastasis or vascular invasion. Total mesorectal excision is the gold standard for these neo plasms and permits very low resection or coloanal anastho mosis with sphinter function preserving. However, this type of surgery has still an high percentageof postoperative mobidity and mortality (some Authors report respectively 40% and 5%). Therefore the local excision on selected cases is able to preserve the sphinter function and to reduce the postoperative complications with high proba bility of recovery.